Intellectual Disability or Mental Retardation KNR 270

DEVELOPMENTAL DISABILITIES  Intellectual disability  (Mental retardation)  Cerebral palsy  Epilepsy  Autism

Intellectual Disability  More frequently used outside US  Increasing use in US AAMR (American Association on Mental Retardation) is now AAIDD (American Association on Intellectual & Developmental Disabilities) 1/2007  7-8 million in US  1% of total population  1/10 families impacted U.S. Dept. of Health & Human Service  Other sources: 3% of total population Carter, Van Andel, & Robb, 2003

MENTAL RETARDATION DEFINITION  Significantly subaverage intellectual function  Concurrent with limitations in adaptive skills 2 or more  Manifested before 18  Person/environment interaction  Similar definition APA in DSM-TR IV & AAMR

Adaptive Skills  Communication  Home living  Using community resources  Work  Free time  Academic achievement  Self-care  Self-direction  Social & interpersonal skills  Health  Safety

MENTAL RETARDATION (old) Functional Levels  %AAMREDUCATORS  89%55-70 mild50-75 educable (EMR)  6%40-55 moderate  3.5%25-40 severe25-50 trainable (TMR)  1.5%0-25 profound0-25 profound

MENTAL RETARDATION (New)  Functional level Mild Moderate  Support level (resources/strategies) Intermittent: As needed Limited: Short time intervals Extensive: Regular basis in some environments Pervasive: Consistent

Mental Retardation  Many causes  3 major causes Fetal alcohol syndrome Down syndrome Fragile X syndrome  1/3 causes unknown Prolonged labor Low birth weight Older mothers Shaken baby syndrome

Fetal Alcohol Syndrome  Caused by mother drinking  Mental & physical birth defects  Growth deficits  Central nervous system dysfunction  Behavioral maladjustments Fetal Alcohol Effect is less severe set of same symptoms 

Fragile X Syndrome  Hereditary  Range of severity  May have behavioral disorders  May have speech & language delays  Trouble processing sounds, sight, smell, sensations,  Do not like to be touched  More severe in males

Down Syndrome  Genetic (extra genetic material from 21 st chromosome)  Flaccid muscles / motor problems  Small fingers and hands /coordination problems  Large tongues & small mouth /language problems  Congenital heart defects (40-45%)  Lung problems  Obesity  Stubborn (central nervous system)

Down Syndrome  Hearing deficits (60-80%)  Premature aging  Early onset Alzheimer’s (age 40)  Atlantoaxial instability (10-20%)  Excessive movement in C1/C2 joint  Doctor’s clearance for SO/sports  Not involve in gymnastics, diving, butterfly swimming stroke, soccer, etc.

Co-Existing Conditions  Cerebral Palsy  Seizure Disorder  Vision Impairment  ADHD  More severe, more likely to have co- existing

Suggestions for Considerations/Accommodations?

Considerations/Accommodations  Assess functional level  Small concrete steps (task analysis)  Allow more time to complete tasks  Repetition  Practice time  Modeling (Demonstrate vs. describe)  Age appropriate Skills & staff interaction No baby talk

Considerations/Accommodations  Have high expectations  May learn slowly  Teach to generalize skills to different environments  Routines  Praise  Facilitate social interaction & appropriate social behaviors  Encourage physical activity  Best Buddies  Others?????